• The Journal of Advanced Prosthodontics
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• 제9권6호
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• pp.416-422
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• 2017

PURPOSE. To investigate the effect of reducing tooth preparation and ceramic thickness on fracture resistance of lithium disilicate crowns. MATERIALS AND METHODS. Specimen preparation included a standard complete crown preparation of a typodont mandibular left first molar with an occlusal reduction of 2 mm, proximal/axial wall reduction of 1.5 mm, and 1.0 mm deep chamfer (Group A). Another typodont mandibular first molar was prepared with less tooth reduction: 1 mm occlusal and proximal/axial wall reduction and 0.8 mm chamfer (Group B). Twenty crowns were milled from each preparation corresponding to control group (n=5) and conditioned group of simultaneous thermal and mechanical loading in aqueous environment (n=15). All crowns were then loaded until fracture to determine the fracture load. RESULTS. The mean (SD) fracture load values (in Newton) for Group A were 2340 (83) and 2149 (649), and for Group B, 1752 (134) and 1054 (249) without and with fatigue, respectively. Reducing tooth preparation thickness significantly decreased fracture load of the crowns at baseline and after fatigue application. After fatigue, the mean fracture load statistically significantly decreased (P<.001) in Group B; however, it was not affected (P>.05) in Group A. CONCLUSION. Reducing the amount of tooth preparation by 0.5 mm on the occlusal and proximal/axial wall with a 0.8 mm chamfer significantly reduced fracture load of the restoration. Tooth reduction required for lithium disilicate crowns is a crucial factor for a long-term successful application of this all-ceramic system.

• The Journal of Advanced Prosthodontics
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• 제7권6호
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• pp.431-436
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• 2015

PURPOSE. The aim of this study was to evaluate occlusal contacts generated by 3 different biogeneric design modes (individual (BI), copy (BC), reference (BR)) of CEREC software and to assess the designs subjectively. MATERIALS AND METHODS. Ten pairs of maxillary and mandibular casts were obtained from full dentate individuals. Gypsum cast contacts were quantified with articulating paper and digital impressions were taken. Then, all ceramic crown preparation was performed on the left first molar teeth and digital impressions of prepared teeth were made. BI, BC, and BR crowns were designed. Occlusal images of designs including occlusal contacts were superimposed on the gypsum cast images and corresponding contacts were determined. Three designs were evaluated by the students. RESULTS. The results of the study revealed that there was significant difference among the number of contacts of gypsum cast and digital models (P<.05). The comparison of the percentage of virtual contacts of three crown designs which were identical to the contacts of original gypsum cast revealed that BI and BR designs showed significantly higher percentages of identical contacts compared with BC design (P<.05). Subjective assessment revealed that students generally found BI designs and BR designs natural regarding naturalness of fissure morphology and cusp shape and cusp tip position. For general occlusal morphology, student groups generally found BI design "too strong" or "perfect", BC design "too weak", and BR design "perfect". CONCLUSION. On a prepared tooth, three different biogeneric design modes of a CAD/CAM software reveals different crown designs regarding occlusal contacts and morphology.

• 대한치과보철학회지
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• 제37권4호
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• pp.416-424
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• 1999

Simulation of naturally appearing enamel in fixed prosthodontics could be achieved with all ceramics. The purpose of this study was to investigate the stain resistance of 4 different all ceramics materials (In-ceram, IPS Empress, Celay, Vintage). Forty specimens were prepared using manifacture's instruction and the samples were divided into two groups. The specimens for one group were glazing and those for other group were ground to remove the glazing layer. All specimens were immersed in methylene-blue for 24hours. The color values for each specimen was measured with colorimeter (Mode Tc-6Fx, Tokyo Denshoku Co.) prior to and after immersion in methylene-blue. The following conclusions were drawn from this study. 1 The stain resistance of glazing ceramics was higher than that of unglazing ceramics. 2. The changes of ${\Delta}E^*$\;and\;L^*$ values were revealed in Vintage and unglazing Celay. 3. The changes of $a^*$ values were revealed in unglazing vintage, Celay, In-ceram. 4. The changes of $b^*$ value were revealed in Vintage, IPS Empress and unglazing Celay.

• 대한치과보철학회지
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• 제46권5호
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• pp.470-478
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• 2008

완전도재 수복물은 뛰어난 심미성을 가지고 있어, 환자들의 심미적 욕구를 충족시킬 수 있다. 이러한 도재관을 제작함에 있어 CAD/CAM 시스템을 이용하는 것은 시간과 비용을 절약할 수 있는 장점을 가지고 있으며, 정밀도 또한 점차 높아지고 있다. 특히 변연적합도는 수복물의 성공 여부에 중요한 요소이고, 이 분야에 대한 실험적 연구는 많이 보고되고 있으나 임상적인 연구는 아직 미흡한 실정이다. 본 연구에서는 CAD/CAM 시스템의 하나인 $Procera^{(R)}$ AllCeram 시스템의 변연적합도를 실제 환자의 수복물 상에서 측정함으로써 임상에 사용되는 CAD/CAM 시스템의 변연적합도를 연구하고자 하였다. 단국대학교 치과병원 보철과에 내원한 56명, 101개의 지대치에 대해 코핑 상태와 최종수복물의 변연오차를 입체광학현미경으로 측정하고 비교분석하여 다음과 같은 결과를 얻었다. 실험 결과, 코핑의 변연오차 ($53.84{\pm}38.83\;{\mu}m$)보다 최종 수복물에서의 변연오차 ($45.82{\pm}30.84\;{\mu}m$)가 더 낮은 값을 나타났으며, 이는 통계적으로 유의한 차이가 있었다 (P < .05). 각 측정 지점간 비교에서 역시 모든 변연에서 코핑 의 변연오차가 최종 수복물에서의 변연오차보다 더 높은 값을 나타냈으며, 통계적으로 유의한 차이가 있었다 (P < .05). 구치부의 변연오차는 전치부의 변연오차보다 더 높은 값을 나타냈으나, 통계적으로 유의한 차이는 없었다. 설측 변연의 경우, 근심, 원심, 순측 변연의 오차보다 더 높은 값을 나타냈으며, 통계적으로 유의한 차이가 있었다 (P < .05). 이상의 결과로 보아 $Procera^{(R)}$ 시스템의 Allceram 관의 변연적합도는 임상적 허용 범위 내에 있었으며, 특히 도재 축성후 변연적합도 는 더 우수해지는 것으로 나타났으며, 각 변연 중 설측 변연의 오차가 가장 큰 것은 주모형의 정보 입력시 순측 부위의 특성상 일어나는 오류로 사료된다. $Procera^{(R)}$ 시스템 Allceram 관 수복시 설측 변연에 더욱 주의를 기울이는 것이 좋은 변연적합을 얻는 데 도움이 될 것으로 사료되며, 앞으로 주모형 변연 부위의 변곡 정도에 따른 변연오차에 대한 연구가 필요할 것으로 사료된다.

• 대한치과보철학회지
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• 제40권2호
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• pp.131-139
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• 2002

There have been many studies about marginal discrepancy of single restorations made by various systems and materials. But many of statistical inferences are not definite because of sample size, measurement number, measuring instruments. etc. The purpose of this study was to compare the marginal adaptations of the anterior single restorations made by different systems and to consider more desirable statistical methods in analysing the marginal fit. The in vitro marginal discrepancies of three different all-ceramic crown systems (Celay In-Ceram. Conventional In-Ceram. IPS Empress 2 layering technique) and one control group (PFM) were evaluated and compared. The crowns were made from one extracted maxillary central incisor prepared with a 1mm shoulder margin and $6^{\circ}$ taper walls by milling machine. 10 crowns per each system were fabricated. Measurements or a crown were recorded at 50 points that were randomly selected for marginal gap evaluation. Non-parametric statistical analysis was performed for the results. Within the limits of this study, the following conclusions were drawn: 1 Mean gap dimensions and standard deviations at the marginal opening for the maxillary incisor crowns were $98.2{\pm}40.6{\mu}m$ for PFM, $83.5{\pm}18.7{\mu}m$ for Celay In-Ceram, $104.9{\pm}44.1{\mu}m$ for conventional In-Ceram, and $45.5{\pm}11.5{\mu}m$ for IPS Empress 2 layering technique. The IPS Empress 2 system showed the smallest marginal gap (P<0.05). The marginal openings of the other three groups were not significantly different (P<0.05). 2 The marginal discrepancies found in this study were all within clinically acceptable standards ($100\sim150{\mu}m$). 3. When the variable is so controlled that the system may be the only one, mean value is interpreted to be the marginal discrepancy of a restoration which is made by each system and standard deviation is to be technique-sensitivity of each one. 4. From the standard deviations. the copy-milling technique (Celay/In-Ceram) was not considered to be technique-sensitive in comparison with other methods. 5. Parametric analysis is more reliable than non-parametric one in interpretation of the mean and standard deviation. The sample size of each group has to be more than 30 to use parametric statistics. The level of clinically acceptable marginal fit has not been established. Further studies are needed.

• 대한치과의사협회지
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• 제50권3호
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• pp.126-139
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• 2012

Loss of dentition can lead to not only compromised esthetics and functions of the patient, but also alveolar bone resorption. Bone grafting with prosthetic reconstruction of the gingiva can be selected for the treatment, and it provides many benefits as prosthetic gingival reconstruction does not require a complicated surgical process and is available within a short period of time, with stable clinical results. However, conventional porcelain fused to metal prosthesis has certain limits due to its size, and deformation after several firing procedures. In this clinical report, the author would like to introduce a patient with severe alveolar resorption who was treated with gingiva-shaped zirconia/titanium CAD/CAM implant fixed prosthesis for esthetic and functional rehabilitation. Clinical reports Clinical report 1, 2 : A case of loss of anterior dentition with atrophied alveolar bone. Implant retained zirconia bridge applied with Procera implant bridge system to simulate the gingiva. Upper structure was fabricated with zirconia all ceramic crown. Clinical report 3, 4 : A case of atrophied maxillary alveolus was reconstructed with fixed implant prosthesis, a CAD/CAM designed titanium structure covered wi th resin on its surface. Anterior dentition was reconstructed with zirconia crown. Conclusion and clinical uses. All patients were satisfied with the outcome, and maintained good oral hygiene. Zirconia/titanium implant fixed prosthesis fabricated by CAD/CAM system was highly accurate and showed adequate histological response. No critical failure was seen on the implant fixture and abutment overall. Sites of severe alveolar bone loss can be rehabilitated by implant fixed prosthesis with CAD/CAM system. This type of prosthesis can offer artificial gingival structure and can give more satisfying esthetics and functions, and as a result the patients were able to accept the outcome more fondly, which makes us less than hard to think that it can be a more convenient treatment for the practitioners.

• 대한치과보철학회지
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• 제46권3호
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• pp.269-279
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• 2008

STATEMENT OF PROBLEM: Recently, various all-ceramic crowns fabricated with CAD/CAM systems have come into wide use in dental clinic. However, there are only few domestic studies on CAD/CAM restorations. PURPOSE: Purpose of this study was to compare the fidelity (absolute marginal discrepancy and internal gap) between various cores fabricated with different CAD/CAM systems (Procera system, Lava system, Cerec inLab system) and conventional metal cast core. MATERIALS AND METHODS: 10 cores per each system were fabricated. The absolute marginal discrepancies were measured using measuring microscope and digital counter. The internal gaps were calculated using a silicone paste. The results were statistically analyzed using the one-way ANOVA test and Tukey's HSD test. RESULTS: Within the limits of this study the results were as follows. 1. The absolute marginal discrepancies were $32.5{\pm}3.7\;{\mu}m$ for metal cast core, $72.2{\pm}7.0\;{\mu}m$ for Procera core, $40.8{\pm}5.4\;{\mu}m$ for Lava core, and $55.3{\pm}8.7\;{\mu}m$ for Cerec inLab core. The internal gaps were $38.4{\pm}5.7\;{\mu}m$ for metal cast core, $71.4{\pm}5.3\;{\mu}m$ for Procera core, $45.9{\pm}7.3\;{\mu}m$ for Lava core, and $51.8{\pm}6.2\;{\mu}m$ for Cerec inLab core. 2. The fidelity of metal cast core showed the smallest gaps, followed by Lava core, Cerec inLab core, and Procera core. CONCLUSION: The fidelities of 4 core groups were all within the clinically acceptable range ($120\;{\mu}m$).

• 대한치과기공학회지
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• 제34권2호
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• pp.75-81
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• 2012

Purpose: All ceramic crown, made from zirconia instead of metal for core material, is recognized the best esthetical prosthesis. Recently, high-priced zirconia blocks and expensive CAD/CAM machines come into use for making zirconia core. In this study, slip casting process is adapted to evaluate the possibility of the recycling the remained parts of zirconia block after machining. Methods: Remained zirconia blocks were reduced to powders with zirconia mortar, and screened with 180 mesh sieve. Passed powders were ball milled under various conditions to obtain the optimum zirconia slip for casting. Solid casting method was used for casting the specimens with plaster mold. Formed specimens were dried and biscuit fired at $1,000^{\circ}C$ for 1 hour. Biscuit fired specimens were finished with exact shape of square pillar. Finished specimens were fired from $1,200^{\circ}C$ to $1,550^{\circ}C$ at $50^{\circ}C$ intervals for 1 hour. Linear shrinkage, apparent porosity, water absorption, bulk density, and flexural strength were tested. Microstructures were observed by SEM. Results: Above examinations indicated that the optimum firing temperture was $1,500^{\circ}C$, and when fired at this temperature for 1 hour, apparent porosity was 0% and flexural strength was 680MPa. SEM photomicrographs showed uniform 200~300nm grain size, which is equal with microcture of sintered commercial zirconia block. when compare 24% linear shrinkage of cast specimen with 20% linear shrinkage of CAD/CAM machined block, it was estimated that the size controlling of cast core was not so difficult. Conclusion: According to the all of this experimental results, the cast zirconia core produced from the remained parts of zirconia block was possible to use for all ceramic denture.

• 대한치과보철학회지
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• 제38권6호
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• pp.791-799
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• 2000

Statement of problem. Targis/Vectris restorations provide excellent esthetics. Marginal accuracy is significantly influenced by the preparation design. There were no studies to examine the effect of preparation design on the marginal discrepancy and fracture strength of Targis / Vectris crowns. Purpose. This study evaluated the marginal accuracy before and after cementation, and the fracture strength of FRC/Ceromer(Targis / Vectris) crowns according to different preparation design. Material and method. Three metal dies with different convergence angles($6^{\circ},\;10^{\circ},\;15^{\circ}$) were prepared. Total 30 (10 for each angle) Targis/Vectris crowns were made. The restorations were evaluated for adaptation of the margin before and after cementation, then were compressively loaded to failure. Fracture surfaces of the crowns were examined using a SEM. Results. The mean marginal gap was $49{\yen}m\;for6^{\circ},\;55{\S}>for\;10^{\circ}\;and\;70{\S}>for\;15^{\circ}$ and in clinically acceptable level. The mean marginal gap increased significantly after cementation. The increasing amount during cementation was the largest in the $6^{\circ}$ group. The crowns on 60 convergence angle had a significantly higher fracture strength than the crowns on $15^{\circ}$ angle. Mean fracture strength of total crowns regardless of convergence angle was 1390 N, which was higher than all-ceramic crowns. SEM observation showed two-mode fracture pattern. Conclusion. From the results of this study, all of the FRC/Ceromer crowns had clinically acceptable marginal accuracy and could withstand the bite force. Moreover, less convergent angle than all-ceramic crown might be recommended for preparation procedure.

• Journal of Periodontal and Implant Science
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• 제38권sup2호
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• pp.405-412
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• 2008

Purpose: Pathologic tooth migration (PTM) commonly occurs in the anterior region and is associated with periodontal disease. The treatment of PTM of anterior teeth can be complex and time consuming, and a multidisciplinary approach is often required. Materials and Methods: The patient was a 38-year-old woman with a chief complaint of saving and realigning her elongated maxillary left central incisor. This paper describes the successful combined periodontal regenerative (guided tissue regeneration) and prosthetic treatment and a 2-year follow-up of maxillary central incisor with pathologic tooth migration, deep intrabony defect, and poor prognosis. Results: The right maxillary central incisor was restored by laminate veneer and the left by all-ceramic crown. The patient had no pain and discomfort and was satisfied with the outcomes of her treatment for 2 years. She has maintained her recall program at the Department of Periodontology at 3 months interval. Conclusion: The key step in the successful treatment of PTM in anterior region is to obtain a high level of cooperation from the patient. Maintenance of the treatment result of PTM is dependent on the continuous preservation of periodontal health.